Podcast
Questions and Answers
What is the typical outcome of fremitus assessment when the lung becomes consolidated with inflammatory exudate?
What is the typical outcome of fremitus assessment when the lung becomes consolidated with inflammatory exudate?
- Unchanged fremitus
- Reduced intensity
- Absent fremitus
- Increased intensity (correct)
Why is fremitus absent in consolidated lung tissue that is not in communication with patent airways?
Why is fremitus absent in consolidated lung tissue that is not in communication with patent airways?
- Because the speech is not transmitted (correct)
- Because the patient is obese
- Because the consolidated tissue is too dense
- Because the patient has asthma
In which patients is fremitus typically reduced?
In which patients is fremitus typically reduced?
- Those with pleural effusion
- Those with pneumonia
- Those with emphysema
- Those who are obese or overly muscular (correct)
What is the effect of hyperinflation on fremitus?
What is the effect of hyperinflation on fremitus?
What is the purpose of having the patient repeat the word 'ninety-nine' during fremitus assessment?
What is the purpose of having the patient repeat the word 'ninety-nine' during fremitus assessment?
Why is it important to palpate the corresponding areas on both sides of the chest during fremitus assessment?
Why is it important to palpate the corresponding areas on both sides of the chest during fremitus assessment?
What is the primary goal of assessing tactile fremitus?
What is the primary goal of assessing tactile fremitus?
What is the reason for reduced fremitus in patients with excess muscle mass?
What is the reason for reduced fremitus in patients with excess muscle mass?
Which of the following conditions is most likely to result in decreased intensity of fremitus?
Which of the following conditions is most likely to result in decreased intensity of fremitus?
During fremitus assessment, what is the purpose of using the palmar or ulnar aspect of the hand?
During fremitus assessment, what is the purpose of using the palmar or ulnar aspect of the hand?
In which of the following conditions would you expect to find increased intensity of fremitus?
In which of the following conditions would you expect to find increased intensity of fremitus?
What is the reason for palpating corresponding areas on both sides of the chest during fremitus assessment?
What is the reason for palpating corresponding areas on both sides of the chest during fremitus assessment?
What is the primary reason for the absence of fremitus in consolidated lung tissue?
What is the primary reason for the absence of fremitus in consolidated lung tissue?
A patient has a pneumothorax in the left lung. What would you expect to find during a fremitus assessment?
A patient has a pneumothorax in the left lung. What would you expect to find during a fremitus assessment?
In which condition would you expect to find increased intensity of fremitus, but only on the right side?
In which condition would you expect to find increased intensity of fremitus, but only on the right side?
What is the purpose of using the ulnar aspect of the hand during fremitus assessment?
What is the purpose of using the ulnar aspect of the hand during fremitus assessment?
What is the primary difference between palpating the anterior and lateral portions of the thorax during fremitus assessment?
What is the primary difference between palpating the anterior and lateral portions of the thorax during fremitus assessment?
Why is it important to assess fremitus in multiple areas of the thorax?
Why is it important to assess fremitus in multiple areas of the thorax?
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Study Notes
Lung Consolidation and Fremitus
- Increased fremitus indicates lung consolidation, typically seen in pneumonia where lung tissue is filled with inflammatory exudate.
- Absence of fremitus occurs when consolidated lung tissue is not connected to open airways, preventing speech transmission.
- Fremitus intensity can be diminished in patients with higher body mass or significant muscle mass.
Decreased Fremitus Causes
- Decreased fremitus occurs when fluid (pleural effusion) or air (pneumothorax) accumulates in the pleural space.
- Conditions causing hyperinflation, such as asthma and emphysema, also lead to reduced fremitus due to decreased lung tissue density.
Assessment of Tactile Fremitus
- Tactile fremitus is assessed by having the patient repeat "ninety-nine" while a respiratory therapist (RT) palpates the chest.
- Palpation involves the anterior, lateral, and posterior thoracic regions using the palmar aspect of the fingers or the ulnar side of the hand.
- If using one hand, it should be transitioned from one side of the chest to the corresponding area on the opposite side for a comparative assessment.
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